Comparison of Single-Dose Prophylactic versus Post-Operative Antibiotic Regimens on Inflammatory Markers and Surgical Site Infection Rates in Laparoscopic Cholecystectomy
DOI:
https://doi.org/10.63682/jns.v14i32S.7925Keywords:
Laparoscopic cholecystectomy, antibiotic prophylaxis, IL-6, TNF-α, surgical site infectionAbstract
Objective: To compare the effects of single-dose pre-operative prophylactic antibiotics versus routine post-operative antibiotic therapy on inflammatory markers, cytokine response, and surgical site infection (SSI) rates in patients undergoing elective laparoscopic cholecystectomy.
Methodology: This prospective comparative study included 80 patients undergoing elective laparoscopic cholecystectomy, divided into two groups (n = 40 each). Group A received a single pre-operative prophylactic dose of antibiotic, while Group B received post-operative antibiotics for five days. Inflammatory markers including total leukocyte count (TLC), neutrophil percentage, neutrophil–lymphocyte ratio (NLR), C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) were measured pre-operatively and 48 hours post-operatively. Patients were followed for 30 days for SSI.
Results: No significant difference was observed between groups in TLC, neutrophil percentage, NLR, CRP, or SSI rates (p > 0.05). However, IL-6 and TNF-α levels were significantly higher in the post-operative antibiotic group compared to the single-dose prophylaxis group (p < 0.05). Hospital stay was significantly shorter in the single-dose group.
Conclusion: Single-dose prophylactic antibiotics are equally effective in preventing SSI and controlling routine inflammatory markers following laparoscopic cholecystectomy. Elevated cytokine levels in the post-operative antibiotic group suggest persistent inflammatory signaling, indicating no additional benefit of extended antibiotic therapy in uncomplicated cases
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